Early Childhood Adversity and Risk for Psychotic Disorder in Adulthood

Understanding the etiology of severe mental disorders, specifically, psychosis, is essential to improvement of prevention and intervention methods. This project investigates the relationship between early childhood adversity (CA) and psychotic disorders in adulthood. It also examines how the effects of other factors, including demographics (sex, ethnicity, SES) and genetic pre-disposition (parent diagnosed with psychosis), affect this relationship. Data are ascertained from a longitudinal birth-cohort study, the National Collaborative Perinatal Project (NCPP), which enrolled pregnant mothers and followed them and their newborn offspring through age seven (1959-1973). Measures of childhood adversity and demographic information were collected prospectively. Adulthood psychiatric outcomes (for both offspring and parents) are derived from two NCPP follow-up studies; adult participants were enrolled, clinically interviewed, and assigned lifetime DSM-IV diagnoses. This project uses a case-control design: the sample includes case groups diagnosed with psychotic, schizotypal, and schizoid disorders and controls without any lifetime DSM-IV diagnoses. Analyses compared rates of psychosis between subjects who were positive and negative for CA; additional analyses examined impact of potential confounders (demographics and genetic predisposition). In bivariate analyses, CA was associated with psychiatric outcome in adulthood (p\u3c.05), as were sex, ethnicity, and parental diagnosis. Trivariate analyses suggested an interactive relationship between CA and parental diagnosis: for subjects with a non-psychotic parent, those with a history of CA were more likely to have a psychotic diagnosis in adulthood than those without CA (p\u3c.05). There was no statistical difference between CA groups for subjects who had a psychotic parent (p\u3e.05). In logistic regression, CA, sex, ethnicity, and parental diagnosis were each significant risk factors for psychosis in adulthood; however, when including the interactive effect between CA and parental psychosis, no specific effect of CA or the interaction between CA and parental psychosis were found. A relationship between CA and psychotic outcome, as well as an interaction between CA and parental psychosis, were suggested. However, results were mixed. Inconsistent results may partially be due to study limitations, including a low rate of CA within the sample. Overall, results are inconclusive, indicating a potential association but need for more research